ATI RN
Intrapartum-Related Complications Questions
Question 1 of 5
The nurse recognizes that fetal scalp stimulation may be prescribed to evaluate the response of the fetus to tactile stimulation. Which conditions contraindicate the use of fetal scalp stimulation? (Select all that apply.)
Correct Answer: A
Rationale: Intrapartum monitoring is crucial to assess fetal well-being during labor. Fetal scalp stimulation is a procedure used to evaluate fetal response to tactile stimulation. In the context of contraindications, a post-term fetus is at risk of decreased amniotic fluid levels and placental insufficiency, making it unsuitable for fetal scalp stimulation as it may further stress the fetus. Maternal fever is a sign of infection, which can lead to fetal distress and compromise fetal well-being, making it a contraindication for fetal scalp stimulation due to the potential exacerbation of the existing condition. Placenta previa, a condition where the placenta partially or fully covers the cervix, poses a risk of hemorrhage during fetal scalp stimulation due to the proximity of the placenta to the cervix. Induction of labor itself is not a contraindication for fetal scalp stimulation. In fact, it may be a reason to perform fetal scalp stimulation to assess fetal well-being during labor induction. Educationally, understanding the contraindications to fetal scalp stimulation is vital for nurses and healthcare providers involved in intrapartum care. It ensures the safety of both the fetus and the mother during labor and delivery. By recognizing these contraindications, healthcare providers can make informed decisions regarding the appropriate interventions for fetal assessment during labor.
Question 2 of 5
A pregnant woman is being seen at her first prenatal visit. The RN should correct which action of a student nurse who is preparing the client for a pelvic examination?
Correct Answer: A
Rationale: In this scenario, the correct answer is option A) Asking the client if she needs something to drink. The student nurse should not offer the client something to drink before a pelvic examination as it can lead to complications if the client requires anesthesia during the procedure. Assembling the necessary equipment (option B) is a crucial step in preparing for a pelvic examination, so this action is appropriate. Positioning the client in the lithotomy position (option C) is also a necessary step for a pelvic examination. Explaining the procedure (option D) is an essential part of providing client-centered care and promoting informed consent. However, ensuring the client's safety and well-being by refraining from offering liquids before the examination takes precedence in this situation. Educationally, this question highlights the importance of understanding pre-procedural care and safety considerations in obstetric settings. It emphasizes the significance of adhering to protocols to prevent potential complications and ensure the best possible outcomes for pregnant clients.
Question 3 of 5
A 26-year-old multigravida patient is 14 weeks pregnant and is scheduled for a maternal serum alpha-fetoprotein test. She asks the nurse, 'What does this test indicate?' The nurse explains that this test can detect which of the following?
Correct Answer: C
Rationale: The correct answer is C) Neural tube defects. The maternal serum alpha-fetoprotein test is a screening test used to detect neural tube defects in the fetus, such as spina bifida or anencephaly. Alpha-fetoprotein is a protein produced by the fetus that crosses into the mother's bloodstream. Elevated levels of alpha-fetoprotein in the maternal serum may indicate a neural tube defect in the developing fetus. Option A) Leg defects, Option B) Gastrointestinal defects, and Option D) Renal defects are incorrect because the maternal serum alpha-fetoprotein test specifically screens for neural tube defects and not for defects in other organ systems. Understanding the purpose of specific prenatal screening tests is crucial in providing comprehensive care to pregnant patients. In an educational context, it is essential for healthcare providers, including nurses, to have a solid understanding of prenatal screening tests and their indications. By knowing the purpose of each test, healthcare professionals can accurately interpret results, provide appropriate information and support to pregnant patients, and facilitate timely interventions if abnormalities are detected. This knowledge ultimately contributes to improving maternal and fetal outcomes by enabling early detection and management of potential complications.
Question 4 of 5
A nurse is performing an initial assessment of a multigravida patient who is 10 weeks gestation. Which assessment finding would necessitate further testing?
Correct Answer: A
Rationale: In this scenario, option A, a rubella titer ratio of 1:10, would necessitate further testing. This is because a rubella titer ratio of 1:10 indicates that the patient is not immune to rubella, which can pose serious risks during pregnancy. Rubella infection during pregnancy can lead to congenital rubella syndrome in the fetus. Option B, blood type A+, is not indicative of a need for further testing in this context as blood type alone does not raise immediate concerns during the initial assessment of a pregnant patient. Option C, a white blood cell count of 5,000, falls within the normal range and does not signal a need for immediate further testing in the absence of other symptoms or clinical indications. Option D, a previous history of gestational diabetes, is relevant information for the patient's care but does not require immediate further testing during the initial assessment unless there are current concerns about blood sugar levels. Educationally, this question highlights the importance of assessing for potential risks and complications early in pregnancy to provide appropriate care and interventions. It emphasizes the significance of immunity status, especially for infectious diseases like rubella, which can have significant implications for both the mother and the developing fetus.
Question 5 of 5
The nurse is caring for a pregnant person who was in a motor vehicle accident when she was younger and broke a bone in her pelvis. For what complication should the nurse be prepared?
Correct Answer: B
Rationale: In this scenario, the correct answer is B) pelvic dystocia. Pelvic dystocia refers to an abnormality in the size and shape of the maternal pelvis, which can obstruct the passage of the fetus during labor. A history of pelvic injury, such as a previous bone fracture in the pelvis due to a motor vehicle accident, can lead to pelvic dystocia. This complication can result in difficulties during labor and an increased risk of cesarean delivery. Option A) fetal dystocia, is incorrect as it refers to issues related to the size, position, or condition of the fetus that may impede its passage through the birth canal. Option C) uterine dystocia, is incorrect as it pertains to abnormalities in the uterus that can affect the progress of labor. Option D) age dystocia, is not a recognized medical term in the context of intrapartum complications. Understanding the impact of prior trauma on maternal health and its potential implications during labor is crucial for healthcare providers caring for pregnant individuals. Awareness of how pelvic injuries can lead to pelvic dystocia underscores the importance of thorough medical histories and appropriate care planning to address any complications that may arise during childbirth.